To gain a more comprehensive understanding of the impact of HIV and AIDS on rural households in Msinga; South Africa; the sustainable livelihoods framework was adapted.

An ethnographic perspective was employed to examine:

1) the impact of HIV/AIDS-related illnesses on people's mind and spirit (the internal environment); and 2) the influence of institutional structures and processes (the external environment); in order to better understand 3) the actions taken by individuals and households in response to HIV and AIDS. Members of three support groups at a local drop-in centre were consulted about the impact of HIV and AIDS on their lives through focus groups; a questionnaire and in-depth interviews. The study shows that the psychosocial impact and associated coping strategies; as well as prevailing gender-based power relations and exclusion from social- exchange networks - which are not (readily) available factors in the sustainable livelihoods framework - affect people's lives in different ways and depend on the specific situation of the individual or household concerned. The study confirms the need to restore a household's resource base and to address psychosocial issues. However; the variation in impact to different households requires a diversified and holistic programme of development interventions